Sleep architecture based on sleep depth and propensity: patterns in different demographics and sleep disorders and association with health outcomes

Sleep

article

Younes, Magdy¹  Gerardy, Bethany²  Pack, Allan I³  Kuna, Samuel T³  Castro-Diehl, Cecilia⁵  Redline, Susan⁵ 

[1] Sleep Disorders Centre, University of Manitoba;YRT Ltd.;Division of Sleep Medicine/Department of Medicine, University of Pennsylvania, Perelman School of Medicine;Department of Medicine, Corporal Michael J. Crescenz Veterans Affairs Medical Center;Department of Medicine, Division of Sleep and Circadian Disorders, Brigham and Women’s Hospital, Harvard Medical School

关键词: odds ratio product;    ORP;    sleep architecture;    quality of life;    Epworth sleepiness scale;    obstructive sleep apnea;    insomnia;   

DOI  :  10.1093/sleep/zsac059

学科分类：生理学

来源: American Academy of Sleep Medicine

【 摘 要 】

Study Objectives Conventional metrics of sleep quantity/depth have serious shortcomings. Odds-Ratio-Product (ORP) is a continuous metric of sleep depth ranging from 0 (very deep sleep) to 2.5 (full-wakefulness). We describe an ORP-based approach that provides information on sleep disorders not apparent from traditional metrics.Methods We analyzed records from the Sleep-Heart-Health-Study and a study of performance deficit following sleep deprivation. ORP of all 30-second epochs in each PSG and percent of epochs in each decile of ORPs range were calculated. Percentage of epochs in deep sleep (ORP 2.25) were each assigned a rank, 1–3, representing first and second digits, respectively, of nine distinct types (“1,1”, “1,2” … ”3,3”). Prevalence of each type in clinical groups and their associations with demographics, sleepiness (Epworth-Sleepiness-Scale, ESS) and quality of life (QOL; Short-Form-Health-Survey-36) were determined.Results Three types (“1,1”, “1,2”, “1,3”) were prevalent in OSA and were associated with reduced QOL. Two (“1,3” and “2,3”) were prevalent in insomnia with short-sleep-duration (insomnia-SSD), but only “1,3” was associated with poor sleep depth and reduced QOL, suggesting two phenotypes in insomnia-SSD. ESS was high in types “1,1” and “1,2”, and low in “1,3” and “2,3”. Prevalence of some types increased with age while in others it decreased. Other types were either rare (“1,1” and “3,3”) or high (“2,2”) at all ages.Conclusions The proposed ORP histogram offers specific and unique information on the underlying neurophysiological characteristics of sleep disorders not captured by routine metrics, with potential of advancing diagnosis and management of these disorders.

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